NCCN Guidelines for Patients
Peripheral T-cell Lymphoma, Version 1.2016
Overview of cancer treatments Stem cell transplant
Stem cell transplant
Hematopoietic stem cells are cells that develop
into mature blood cells. Hematopoietic stem cells
and mature blood cells are made in bone marrow.
Cancer or its treatment can damage or destroy the
cells in bone marrow. A stem cell transplant replaces
damaged or destroyed stem cells with healthy stem
cells, which form new marrow and blood cells. There
are two types of stem cell transplant.
Autologous stem cell transplant uses your healthy
stem cells to repair bone marrow. This treatment
is also called HDT/ASCR (
escue). Healthy stem cells will
be collected from you when imaging tests show that
cancer treatment is working. You will then receive
intense chemotherapy and maybe radiation to destroy
any remaining cancer cells. This intense treatment
will also destroy bone marrow, so your healthy stem
cells will be put back into your body to “rescue” your
Allogeneic stem cell transplant uses healthy stem
cells that come from a donor. HLA (
ntigens) typing is the test used to check if the donor
and your tissue type are a good fit. Chemotherapy will
be given to destroy cancer cells and suppress your
immune system from attacking the donor cells. The
transplanted stem cells will form new marrow and
attack remaining cancer cells. This attack is known
as the GVT (
umor) effect. On the other
hand, there is a serious risk of GVHD (
isease). GVHD is when the donated cells see
the cells in your body as foreign and attack them.
A stem cell transplant is not an option for every
person with peripheral T-cell lymphoma. A stem
cell transplant can have severe side effects so it is
not given to people who are frail or quite sick. An
autologous transplant may be given only when prior
drug treatment appears to have worked. An allogeneic
transplant may be an option after a second course
of drug treatment. Autologous stem cell transplant is
more commonly used for peripheral T-cell lymphoma.
More details on this transplant are given next.
Collecting your stem cells
The first step of an autologous stem cell transplant
is to collect, or harvest, the blood stem cells. Blood
stem cells are found in the bone marrow and in the
bloodstream. If stem cells are collected from blood, a
process called apheresis will be done. First, medicine
is sometimes given to increase the number of stem
cells in blood. Then, some blood will be removed from
a large vein most likely in your arm. The blood will
flow through a tube and into a machine that removes
stem cells. The rest of the blood will be returned
through the other arm.
Apheresis typically takes 4 to 6 hours and does not
require anesthesia. It may take two or more sessions
to obtain enough stem cells. During the procedure,
you may have lightheadedness, chills, numbness
around the lips, and cramping in the hands.
Bone marrow aspiration is used to remove bone
marrow. For this procedure, either regional anesthesia
or general anesthesia will be given. Next, a needle
will be inserted through the skin into the hip bone
to draw out the bone marrow. The needle must be
inserted many times into one or more spots to collect
enough marrow. The marrow will then be processed
to collect the stem cells.
Collection of the bone marrow takes about 1 hour.
The entire hospital stay will likely be 6 to 8 hours,
which includes recovery time. The aspiration will
likely cause some pain and soreness for a few days.
Anesthesia may cause nausea, headache, and
After apheresis or aspiration, the harvested cells
will be combined with a preservative. Then, they will